Ask what the patient wants to improve, including pelvic-floor weakness, stress leakage or difficulty performing voluntary pelvic-floor contractions. Take a relevant medical and surgical history, explain the treatment and agree how progress will be assessed.

Not all pelvic-floor symptoms are caused by weakness. Pelvic pain, difficulty relaxing the muscles, prolapse symptoms or unexplained bladder and bowel problems may require assessment by an appropriately qualified pelvic-health professional before chair treatment is considered.

M1, M2 and M3 are preset programme selections. For our usual pelvic-floor strengthening treatments, we generally stay in M1 and tailor the three frequencies within it.

F1, F2 and F3 are the frequency settings used across the stages of the selected treatment. They are not instructions to use M1 with F1, M2 with F2 and M3 with F3.

The screen also allows adjustment of treatment time and intensity. Frequency and intensity are separate controls: a higher frequency changes the pattern of muscle stimulation, while intensity determines how strongly the patient experiences it.

Our training recommends beginning at a level the patient can tolerate. The contractions should be noticeable and reasonably challenging, but never so strong that the patient feels unable to continue or experiences pain.

At the first appointment, record the selected F1, F2 and F3 values and intensity. A photograph of the touchscreen is an easy way to keep an accurate reference alongside the clinical notes.

At later appointments, an increase of around 10% may be used as a practical guide where the patient has tolerated the previous treatment well. It is not a mandatory increase: hold or reduce settings if comfort, symptoms or recovery suggest it is appropriate.

Ask the patient to sit facing forwards, with the pelvic-floor area centred over the treatment zone. In practical terms, we generally position the vaginal area just behind the raised section of the seat.

Patients can often tell when they are in the right position because the contractions feel more clearly centred around the pelvic floor. Before progressing to stronger stimulation, it can help to pause and let the patient adjust slightly forwards or backwards.

If the patient sits too far back, for example, they may report feeling more stimulation in the backs of the thighs than in the intended area. Reassess positioning rather than immediately increasing intensity.

The exact sensation varies between patients. If the response is unclear or uncomfortable, stop and reassess before continuing.

Patients can remain fully clothed for their Supramax appointment, which makes the treatment discreet and straightforward.

However, we find that heavy clothing can affect the treatment experience. Thick denim jeans and bulky skirts are less suitable than soft, relatively thin garments.

We recommend leggings, jogging bottoms or similarly lightweight trousers. This makes it easier to position the patient comfortably and to assess the sensation of contraction. Metal accessories should be removed before treatment.

Supramax has a Strength mode and a separate Recovery mode. Strength mode is designed around muscle stimulation for strengthening; Recovery mode uses a gentler approach intended for relaxation following exercise.

Recovery mode can be useful where a patient is also performing voluntary pelvic-floor exercises, for example as part of a supervised pelvic-floor physiotherapy programme. It may be used following that exercise routine as a finishing or recovery stage.

In our experience, many people attending for chair treatment struggle to contract their pelvic-floor muscles voluntarily. As a result, most clinics we support primarily use the strength programme, and Recovery mode is used less often.

Recovery mode is not a compulsory extra stage at the end of every 30-minute chair treatment.

Many patients can return to ordinary activities after their appointment. Encourage them to remain seated briefly at the end, especially following their first session, and check that they feel well before standing.

Pure Tone training notes that some patients may notice mild temporary aching in the abdomen or hip area, fatigue, or a change in the urge to pass urine or open their bowels. This can vary with the intensity and individual response.

Ask patients to contact the clinic if symptoms are unusual, prolonged or worsening. Significant pain, new difficulty passing urine or other concerning symptoms require appropriate medical assessment.

There is no postnatal waiting period specified in Pure Tone's Supramax training presentation, and the recovery process is different for every patient.

As a conservative practical precaution, we advise that chair treatment should not be considered earlier than 12 weeks after childbirth and should only proceed following appropriate postnatal assessment and medical clearance. Twelve weeks is a precautionary starting point, not proof of suitability or an established Supramax-specific clinical threshold.

Recovery from a caesarean section, significant tearing, persistent pelvic pain, prolapse symptoms or other complications may require a longer wait and specialist pelvic-health assessment.

Our training materials also list breastfeeding among treatment restrictions. Clinics should therefore check breastfeeding status as part of screening and should not interpret the 12-week interval as permission to treat someone who remains within an exclusion listed in their current clinical protocol.